ERISA Remand Orders Without a Sum-Certain Benefits Award Are Not Final and Are Appealable Only After Post-Remand District Court Disposition

1. Introduction

In W. v. California Physicians Service (10th Cir. May 21, 2026), Kirsten W., individually and on behalf of her minor son C.W., sued California Physicians' Service (d/b/a Blue Shield of California) and Trinet Group, Inc. Section 125, Section 129, and Flexible Spending Account Plan (collectively tied to an ERISA-governed benefits arrangement) after denial of benefits for C.W.’s residential behavioral health treatment at two facilities.

The operative complaint alleged violations of ERISA and the Mental Health Parity & Addiction Equity Act of 2008 (the “Parity Act”). On cross-motions for summary judgment, the district court (i) ruled for plaintiffs on an ERISA claim, (ii) ruled for Blue Shield on the Parity Act claim, and (iii) granted summary judgment to Trinet on all claims—while also remanding to the plan administrator to determine the amount of benefits owed.

Kirsten appealed. The Tenth Circuit raised a jurisdictional concern: whether the district court’s order was a final decision under 28 U.S.C. § 1291. The central issue on appeal thus became appellate jurisdiction, not the underlying merits of medical necessity or parity compliance.

2. Summary of the Opinion

The Tenth Circuit dismissed the appeal for lack of jurisdiction, holding that the district court’s order was non-final because it remanded to the plan administrator to determine benefits (i.e., it did not award a sum certain), and contemplated further proceedings—including potential future involvement of Trinet depending on what occurred on remand.

The court also provided practical guidance: after the administrator issues a new decision on remand, a party ordinarily may seek judicial review by a timely motion in the same civil action in district court (rather than filing a new lawsuit). Only after the district court resolves post-remand proceedings in a way that leaves nothing further to do may a party file a valid appeal.

3. Analysis

3.1. Precedents Cited

  • In re Motor Fuel Temperature Sales Practices Litigation, 641 F.3d 470 (10th Cir. 2011): Cited for the overarching principle that appellate jurisdiction generally lies only after the district court’s work is complete.
  • S.E.C. v. Merrill Scott & Associates, Ltd., 600 F.3d 1262 (10th Cir. 2010) (quoting Boughton v. Cotter Corp., 10 F.3d 746 (10th Cir. 1993)), and Frank v. Crawley Petroleum Corp., 992 F.3d 987 (10th Cir. 2021): Used to restate the classic definition of finality—whether the order ends the litigation on the merits and leaves nothing but execution of judgment.
  • Liberty Mut. Ins. Co. v. Wetzel, 424 U.S. 737 (1976): Supports that orders leaving remedy unresolved are typically non-final.
  • Metzger v. UNUM Life Ins. Co. of America, 476 F.3d 1161 (10th Cir. 2007): Establishes the Tenth Circuit’s “case-by-case approach” to finality of ERISA remand orders.
  • Spradley v. Owens-Illinois Hourly Employees Welfare Ben. Plan, 686 F.3d 1135 (10th Cir. 2012): Provides the operative test: ERISA remand orders are not final where issues remain on remand and arguments can be reviewed after completion.
  • Rekstad v. First Bank System, Inc., 238 F.3d 1259 (10th Cir. 2001), and Albright v. UNUM Life Ins. Co. of America, 59 F.3d 1089 (10th Cir. 1995): Central to the holding—an order remanding to determine the “correct amount” of benefits/damages is non-final; lack of a “sum certain” generally defeats finality.
  • Mobile, J. & K.C.R. Co. v. Mississippi, 210 U.S. 187 (1908): Cited for the jurisdictional axiom that alleged error—even demonstrable error—does not itself confer appellate jurisdiction.
  • David P. v. United Healthcare Insurance Company, 77 F.4th 1293 (10th Cir. 2023): Used to validate the district court’s stated guardrails on remand—preventing the administrator from changing rationales beyond what the administrative record conveyed.
  • Graham v. Hartford Life & Accident Ins. Co., 501 F.3d 1153 (10th Cir. 2007): Discusses “practical finality” and the narrow circumstances in which immediate review of a remand might be permitted.
  • Cross-circuit guidance on post-remand procedure: Petralia v. AT&T Global Information Solutions Co., 114 F.3d 352 (1st Cir. 1997); Mead v. Reliastar Life Ins. Co., 768 F.3d 102 (2d Cir. 2014); Card v. Principal Life Insurance Company, 17 F.4th 620 (6th Cir. 2021); Stevens v. Santander Holdings USA Inc., 799 F.3d 290 (3d Cir. 2015). These authorities support that the district court typically retains jurisdiction during remand and post-remand review proceeds via motion practice in the same case.

3.2. Legal Reasoning

The court’s reasoning is a straightforward application of § 1291 finality principles to an ERISA remand posture:

  1. Finality requires completion. The court emphasized that a “final decision” ends the litigation and leaves nothing but execution. Where the district court sends the dispute back for further decision-making, the case is not complete.
  2. ERISA remands are usually non-final when issues remain. Applying Spradley v. Owens-Illinois Hourly Employees Welfare Ben. Plan, the court reasoned that because benefits still had to be calculated/decided on remand, appellate review could occur later after those issues were resolved.
  3. No “sum certain,” no final judgment. The opinion relies heavily on Rekstad v. First Bank System, Inc. and Albright v. UNUM Life Ins. Co. of America: a judgment that does not specify a determinate amount of benefits/damages is ordinarily non-final, including in ERISA benefits litigation.
  4. Potential future proceedings underscore non-finality. The district court’s reasoning as to Trinet contemplated future liability depending on what happens on remand (e.g., nonpayment or an arbitrary denial), confirming that the litigation had not reached a terminal posture.
  5. Alleged error does not create jurisdiction. The appellant’s arguments that the district court wrongly dismissed Trinet or issued an overly broad remand were treated as merits objections that cannot substitute for statutory jurisdiction under Mobile, J. & K.C.R. Co. v. Mississippi.
  6. “Practical finality” narrowly confined. Although Graham v. Hartford Life & Accident Ins. Co. recognizes a limited possibility of reviewing remand orders where important issues would become “effectively unreviewable,” the court found no such showing here; any remand-scope problems could be raised in district court and later appealed.
  7. Procedural guardrails were already present. The court rejected the characterization of the remand as “boundless,” noting the district court adopted limitations consistent with David P. v. United Healthcare Insurance Company—particularly that the administrator may not rely on new rationales not previously conveyed in the administrative record.

3.3. Impact

Although labeled a non-precedential “Order and Judgment,” the decision reinforces (and practically explains) a rule that will meaningfully shape ERISA appellate practice in the Tenth Circuit:

  • Appeals are premature when benefits remain to be calculated on remand. Parties should expect dismissal if the district court remands for a benefits-amount determination and does not enter a sum-certain award.
  • “Judgment entered” is not the same as “final for § 1291.” Even if the district court closes the case on the docket, remand orders may remain non-final if the court effectively retains jurisdiction and further proceedings are anticipated.
  • Post-remand review should proceed by motion in the same case. By endorsing Petralia v. AT&T Global Information Solutions Co. and similar cases, the court provides litigants and district courts a clear procedural roadmap, reducing the risk of unnecessary new filings and statute-of-limitations confusion.
  • Practical finality remains a steep climb. The opinion signals that attempts to fit ERISA remands into the “effectively unreviewable” category will continue to face skepticism, absent a concrete showing that later review is impossible.

4. Complex Concepts Simplified

  • Final judgment (28 U.S.C. § 1291): Generally, you can appeal only after the district court has fully finished the case—both liability and remedy—so there’s nothing left to decide.
  • Remand in ERISA cases: The district court sends the matter back to the plan administrator to redo (or complete) the benefits decision under the proper legal standards. If remand leaves real work to be done, the case is usually not appealable yet.
  • “Sum certain”: A specific, fixed dollar amount awarded. If the court says “you win, but the administrator must calculate how much,” that is typically not final.
  • Practical finality: A narrow exception allowing appeal of some non-final orders if waiting would make the issue effectively impossible to review later. The Tenth Circuit treats this as rarely available in ERISA remand situations.
  • Administrative record / new rationale bar: The administrator ordinarily cannot deny benefits on remand using brand-new reasons that were not part of the prior record and communications, reflecting the guardrails discussed via David P. v. United Healthcare Insurance Company.

5. Conclusion

W. v. California Physicians Service reaffirms that an ERISA order remanding to the administrator to determine the amount of benefits—without a sum-certain award—is generally not a final decision under 28 U.S.C. § 1291 and therefore is not immediately appealable. The opinion’s most practical contribution is procedural clarity: after the administrator’s post-remand decision, the losing party ordinarily should seek review by motion in the same district court case, and only after the district court conclusively resolves post-remand proceedings does the time for a proper appeal arrive.